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Internet-Based Therapy for Mild to Moderate Depression in Swedish Primary Care: Short Term Results from the PRIM-NET Randomized Controlled Trial

Artikel i vetenskaplig tidskrift
Författare Marie Kivi
Maria Christina Eriksson
Dominique Hange
Eva-Lisa Petersson
Kristofer Vernmark
Boo Johansson
Cecilia Björkelund
Publicerad i Cognitive Behaviour Therapy
Volym 43
Nummer/häfte 4
ISSN 1650-6073
Publiceringsår 2014
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Psykologiska institutionen
Språk en
Länkar dx.doi.org/10.1080/16506073.2014.92...
Ämnesord depression; Internet-based treatment, ICBT; primary care; effectiveness; randomized controlled trial
Ämneskategorier Allmän medicin, Psykologi

Sammanfattning

Depression presents a serious condition for the individual and a major challenge to health care and society. Internet-based cognitive behavior therapy (ICBT) is a treatment option supported in several trials, but there is as yet a lack of effective studies of ICBT in “real world” primary care settings. We examined whether ICBT differed from treatment-as-usual (TAU) in reducing depressive symptoms after 3 months. TAU comprised of visits to general practitioner, registered nurse, antidepressant drugs, waiting list for, or psychotherapy, or combinations of these alternatives. Patients, aged $18 years, who tentatively met criteria for mild to moderate depression at 16 primary care centers in the south-western region of Sweden were recruited and then assessed in a diagnostic interview. A total of 90 patients were randomized to either TAU or ICBT. The ICBT treatment included interactive elements online, a workbook, a CD with mindfulness and acceptance exercises, and minimal therapist contact. The treatment period lasted for 12 weeks after which both groups were assessed. The main outcome measure was Beck Depression Inventory-II (BDI-II). Additional measures were Montgomery A ° sberg Depression Rating Scale – self rating version (MADRS-S) and Beck Anxiety Inventory (BAI). The analyses revealed no significant difference between the two groups at post treatment, neither on BDI-II, MADRS-S, nor BAI. Twenty patients (56%) in the ICBT treatment completed all seven modules. Our findings suggest that ICBT may be successfully delivered in primary care and that the effectiveness, after 3 months, is at par with TAU.

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